Bartonella henselae infective endocarditis with dissemination: A case report and literature review in Southeast Asia

Abstract

Bartonella is among the most common causes of culture-negative infective endocarditis, with B. henselae being one of the most frequently reported species. The clinical presentation of Bartonella endocarditis is similar to that of subacute bacterial endocarditis caused by other bacteria and the diagnosis can be challenging since the organism is difficult to isolate using standard microbiologic culture techniques. In clinical practice, Bartonella endocarditis is usually diagnosed based on serology. To date, only a handful of cases of infective endocarditis caused by Bartonella have been reported in Thailand. Here, we report the case of 51-year-old Thai male with B. henselae endocarditis with dissemination to the lungs, bones, subcutaneous tissue, epididymis, and lymph nodes with a successful outcome.

Keywords: Bartonella; Bartonella endocarditis; Bartonella henselae; Culture-negative endocarditis; Disseminated Bartonella henselae infection.

Fig. 1

Chest and abdominal computed tomogram. Left (axial view): arrow shows a mass-forming lytic lesion at the left anterior sixth rib and more prominent bilateral pleural effusion at the right side. Right (sagittal view and bone window): image shows multiple lytic lesions in the spine.

Fig. 2

Transesophageal echocardiogram showing a vegetation at the aortic valve leaflet (0.9 × 0.5 cm in size).

Fig. 3

PCR amplification of pap31 gene. Lane M: 100 bp DNA ladder markers; Lane 1: DNA isolated from patient’s blood sample; Lane 2: positive control bacterial DNA (B. henselae); Lane 3: negative control bacterial DNA (S. pneumoniae).